Provider Demographics
NPI: | 1780122440 |
---|---|
Name: | BAGGERLEY THERAPY SERVICES |
Entity type: | Organization |
Organization Name: | BAGGERLEY THERAPY SERVICES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER, OCCUPATIONAL THERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RYAN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BAGGERLEY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MOTR |
Authorized Official - Phone: | 214-675-5609 |
Mailing Address - Street 1: | 1673 VAUGHAN CT |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75208-0107 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 214-675-5609 |
Mailing Address - Fax: | 214-242-8078 |
Practice Address - Street 1: | 1673 VAUGHAN CT |
Practice Address - Street 2: | |
Practice Address - City: | DALLAS |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75208-0107 |
Practice Address - Country: | US |
Practice Address - Phone: | 214-675-5609 |
Practice Address - Fax: | 214-242-8078 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2017-02-02 |
Last Update Date: | 2017-02-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 111798 | 225XF0002X, 225XL0004X, 225XN1300X, 225XP0019X, 225XP0200X, 225XR0403X, 225X00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 225XF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Feeding, Eating & Swallowing | Group - Multi-Specialty |
No | 225XL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Low Vision | Group - Multi-Specialty |
No | 225XN1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Neurorehabilitation | Group - Multi-Specialty |
No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation | Group - Multi-Specialty |
No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
No | 225XR0403X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Driving and Community Mobility | Group - Multi-Specialty |